Ohio AAP Program Medical Director Hub

Ohio AAP Program Medical Director Hub

Contact Information

First Name

Last Name

Credentials

Institution/Organization

Email Address

Twitter Handle

Work Phone

Mobile Phone

Preferred Contact Method

Email

Work Phone

Mobile Phone (Call)

Mobile Phone (Text)

Practice Administrator

Practice Administrator Information

Practice Administrator Name

Practice Administrator Email Address

Practice Administrator Phone Number

Meeting Availability

Please select the best day(s) of the week for meetings/phone calls:

Monday

Tuesday

Wednesday

Thursday

Friday

Mondays

Please list preferred time(s).

Tuesdays

Please list preferred time(s).

Wednesdays

Please list preferred time(s).

Thursdays

Please list preferred time(s).

Fridays

Please list preferred time(s).

CME Information

Please complete a CME Disclosure by visiting: https://www.surveymonkey.com/r/OhioAAPCOI

Please upload an Electronic Signature, a copy of your CV, and a brief Bio for our records.

Drop a file here or click to upload Choose File

Maximum upload size: 134.22MB

If you are human, leave this field blank.

Please bookmark the following Dropbox Link, which contains the below items: https://www.dropbox.com/sh/6cdlf6mz0v6bocu/AABy02uD3tETJdapd7JS2KWca?dl=0

General Chapter:

• Meeting/Event Schedule
  • Information about annual events, with required meetings in bold.
• Staff/Board Contact List

Monthly Forms:

• Invoice (for Salary purposes)
• Timesheet

Templates:

• Ohio AAP PowerPoint Template
  • Please use this for all presentations (internal and external) about your program
• Ohio AAP Poster Template
  • Please use for all poster presentations about your program
• Electronic Letterhead